Raymond Bennett started running when he was 10 and over the years played basketball and soccer too.

As an avid outdoorsman, he also went hiking, camping and fly fishing whenever he could.

But earlier this year, a pain in the bottom of his foot kept him from his beloved passtimes for months and threatened his livelihood as well.

“I got to the point where I limited most of my ... activities and I could not bear weight on my right foot,” the Gray Court man told The Greenville News.

And as a project manager for an overhead crane company who spent most of his work day on his feet supervising construction sites, that became a challenge, too.

So the 45-year-old finally decided to consult a doctor.

“I really didn’t feel like I had a whole lot of choices,” he said. “It was either change careers to something sedentary or do something to get it fixed.”

Bennett suffered from plantar fasciitis, a painful condition marked by tiny tears in the plantar fascia ─ the connective tissue that supports the arch of the foot.

Plantar fasciitis afflicts about 10 percent of the adult population, said Dr. John W. Womack III, an orthopedic surgeon and foot and ankle specialist with Bon Secours Medical Group’s Piedmont Orthopaedic Associates. In fact, he said, it’s the single most common diagnosis he sees.

“Plantar fasciitis is tennis elbow in your foot,” he said. “It’s caused by microscopic tears in the fascia, which is the suspension bridge that holds your arch up.”

‘Walking on a hot nail’

The condition is believed to be caused by a variety of things, including too much activity like running, obesity, and foot abnormalities like a high arch or flat foot, he said. And it’s very painful.

“Some people tell me it feels like walking on a hot nail,” he said

While it can resolve on its own, Womack said stretching exercises, orthotics, physical therapy, night splints and pain relievers are often needed.

But if that doesn’t help, he said, surgery is an option.

Previously, surgeons performed an open operation with a 3-inch or larger incision that risked damaging healthy tissue and required months of recovery with restricted activity, he said.

But a new minimally-invasive same-day surgery is now available that uses ultrasound-guided technology, he said. First, the problem spot is pinpointed and then a tiny incision is made through which a probe is inserted that sends ultrasound energy to break down and remove the damaged tissue, he said. It’s done using technology developed by Tenex Health of California.

“The incision is so small you don’t even have a stitch in it. Just a Steri-Strip,” he said. “The old way was to do a big open operation and take a knife and release the entire fascia.”

Patients typically leave the recovery room under their own steam in a special walker boot, he said. Two weeks later, the boot is removed and a stretching program is begun. They’re back to normal in about 12 weeks, he said.

With the open surgery, about two thirds of patients see improvement compared with 80 percent of those who have the minimally-invasive surgery, Womack said.

The procedure is covered by insurance, he said, and the only real complication is that it might not work.

“I haven’t seen an infection yet,” he said.

A new life

Womack said he’s done the procedure, which takes about 20 minutes to do with the patient under conscious sedation, on about 30 patients in the three months he's been doing it and about 80 percent have done well.

About three quarters of them are athletes or weekend warriors, he said.

Bennett, who is married with three children, had plantar fasciitis in his left foot three years ago, which resolved with standard treatments.

But earlier this year, the right foot began acting up and continued to get worse despite using the same stretching and night splint techniques he’d used before.

“It was six months before I realized I was not getting better,” he said. “I could walk no more than 10 minutes at a time without having a limp.”

Womack told him his options, which ranged from steroid shots to open surgery. Then he told Bennett about the new procedure, which is also done at Greenville Health System.

“I had to do something or walk around and hurt or be in a cast or immobilized, which is not an option for my job,” he said.

So Bennett had his surgery done on a Thursday in early October and was back at work the following Monday. While it still hurt initially, he said, it progressively improved and after about five or six weeks, the pain was gone.

Now, he said, he’s looking forward to some fishing trips planned for next year.

“Before, I was not able to do a lot of things I enjoyed and I was limited in how long I could get out on the job site and effectively do my job. Now I’m able to do all those things,” he said. “I’m very glad I did it.”